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脓毒症和脓毒性休克中免疫凝血的新机制

Emerging mechanisms of immunocoagulation in sepsis and septic shock.

作者信息

Tang Daolin, Wang Haichao, Billiar Timothy R, Kroemer Guido, Kang Rui

机构信息

The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China; Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA.

Laboratory of Emergency Medicine, North Shore University Hospital and the Feinstein Institute for Medical Research, Manhasset, NY 11030, USA.

出版信息

Trends Immunol. 2021 Jun;42(6):508-522. doi: 10.1016/j.it.2021.04.001. Epub 2021 Apr 24.

Abstract

Sepsis and septic shock driven by microbial infections are still among the most challenging health problems, causing 11 million deaths worldwide every year. How does the host's response to pathogen infections effectively restore homeostasis instead of precipitating pathogenic and potentially fatal feedforward reactions? Recently, there have been significant new advances in our understanding of the interface between mammalian immunity and coagulation ('immunocoagulation') and its impact on sepsis. In particular, the release and activation of F3 (the main initiator of coagulation) from and on myeloid or epithelial cells is facilitated by activating inflammasomes and consequent gasdermin D (GSDMD)-mediated pyroptosis, coupled to signaling via high mobility group box 1 (HMGB1), stimulator of interferon response CGAMP interactor 1 (STING1), or sequestosome 1 (SQSTM1). Pharmacological modulation of the immunocoagulation pathways emerge as novel and potential therapeutic strategies for sepsis.

摘要

由微生物感染引起的脓毒症和脓毒性休克仍然是最具挑战性的健康问题之一,每年在全球导致1100万人死亡。宿主对病原体感染的反应如何有效地恢复体内平衡,而不是引发致病性和潜在致命的前馈反应?最近,我们对哺乳动物免疫与凝血之间的界面(“免疫凝血”)及其对脓毒症的影响有了重大的新进展。特别是,通过激活炎性小体以及随后由gasdermin D(GSDMD)介导的细胞焦亡,再加上通过高迁移率族蛋白B1(HMGB1)、干扰素反应刺激物CGAMP相互作用蛋白1(STING1)或聚集体蛋白1(SQSTM1)的信号传导,促进了F3(凝血的主要启动因子)在髓样细胞或上皮细胞上的释放和激活。免疫凝血途径的药理学调节已成为脓毒症新的潜在治疗策略。

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